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NPI Code Detail

MEDICARE: SUSANNA WARNER PA, LLP

MEDICARE: SUSANNA WARNER PA, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601007902MI
2103T00000XPsychologist6301008248MI

General Provider Information

NPI Number : 1811905508
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANNA WARNER PA, LLP
Provider Business Mailing Address
First Line : 1040 W BRISTOL RD
Second Line :
City : FLINT
State : MI
Zip : 48507-5516
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1040 W BRISTOL RD
Second Line :
City : FLINT
State : MI
Zip : 48507-5516
Country : US
Telephone Number : 999-999-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 12/19/2025

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Directions to “ SUSANNA WARNER PA, LLP” Practice Location

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